1. Stroke Dr Jane Molloy – Clinical Lead Stroke Services SRFT

2. Background: What is a stroke? How do we ‘know’ there’s a stroke? Why do people have strokes? What can we do to prevent a stroke? What should we do – is there any treatment? Salford Stroke Services Stroke

3. Brain is the ‘control centre’ –Planning –Thinking –Movement –Sensation –Memory –Balance –Speech –Language –Hearing, vision What is a stroke?

4. Delivery of oxygen, glucose Taking away ‘waste’ What is a stroke?

5. 8 out of 10 due to blood clot 2 out of 10 due to bleeding

6. How do we ‘know’ there’s a stroke? FAST Video

7. SUDDEN loss of function what is lost depends on which blood vessel is affected we can only tell if there was bleeding by doing a scan Loss of: power = movement feeling = numbness vision = one eye / to one side balance speech – slurring vs wrong words blackout unusual How do we ‘know’ there’s a stroke?

9. Is Stroke Important? 1 stroke every 5 minutes – England & Wales 3000/year Greater Manchester 50% dead or disabled at 6 months 1:4 of those living >80 years In women – 3x deaths from breast cancer 2002

10. How can we prevent a stroke?

11. Modifiable Risk Factors Risk factorExcess stroke risk High Blood Pressure4 – 6 Smoking1.5 – 4 Ischaemic Heart disease3 – 4 Cholesterol*Unclear Diabetes2 Excess alcohol5 Physical inactivity1.6 – 3.3 Weight/dietVariable

12. Blood Pressure Blood pressure <140/85 BP gets higher with age Reduce salt Reduce weight Tablets Self monitoring

13. Smoking Don’t! Smoking cessation –advice & support –signposting

14. Cholesterol What’s yours? Statins reduce death from heart attack and stroke by 1/3 Dietary changes can help cholesterol but not always

15. Atrial Fibrillation

16. Weight & Diet

17. Exercise Controls weight Improves cholesterol Prevents diabetes Improves mood and helps depression Improves energy levels Improves sleep Improves sexual function Is fun Why don’t we do it?

18. Preventing Strokes troke

19. And if despite all that.. Admit to a hospital with a specialist stroke unit Urgent brain scanning and assessment Clot busting treatment if possible –Time is Brain Stroke Unit Care

20. Stroke Services – Greater Manchester From this…2006

21. To this…from 2010 Salford BuryStockport All others

23. Life After Stroke Rehabilitation –In hospital –Early Supported Discharge –Community rehabilitation Life after Stroke Care Secondary Prevention

24. Stroke at SRFT 8 consultants Service for Greater Manchester 24/7 acute specialist stroke assessment –Specialist nurses & Drs >500 patients thrombolysed Daily TIA clinics – direct referrals

25. Thank you Questions?